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Kawabe K, Horiuchi F, Matsumoto Y, Inoue S, Okazawa M, Hosokawa R, Nakachi K, Soga J, Ueno S. Practical clinical guidelines and pharmacological treatment for attention-deficit hyperactivity disorder in Asia. Neuropsychopharmacol Rep 2024; 44:29-33. [PMID: 38059346 PMCID: PMC10932761 DOI: 10.1002/npr2.12381] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Revised: 09/11/2023] [Accepted: 09/16/2023] [Indexed: 12/08/2023] Open
Abstract
Attention-deficit hyperactivity disorder (ADHD) is characterized by persistent symptoms of inattention, hyperactivity, and impulsivity. Both, stimulant and nonstimulant medications have been approved for the treatment of this disorder. Several Western guidelines recommend the use of prescribed Food and Drug Administration (FDA)-approved medications for ADHD along with parental training in behavior management and behavioral classroom intervention. In 2022, new Japanese guidelines for ADHD were issued, which recommended school environment management and psychosocial treatment as the first-line treatment, with pharmacological treatment added as the second-line treatment. Although Japanese guidelines, including pharmacological treatments, have been established, the guidelines and utilization of ADHD medications across Asian regions are unclear. Therefore, to appropriately evaluate the strategy of pharmacological treatments for ADHD, we investigated Asian regional guidelines for ADHD medication in children. We also reviewed the guidelines in Malaysia, Singapore, India, and the Republic of Korea and found that these guidelines differ from Western guidelines.
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Affiliation(s)
- Kentaro Kawabe
- Department of Child PsychiatryEhime University Graduate School of MedicineToon CityJapan
| | - Fumie Horiuchi
- Department of Child PsychiatryEhime University Graduate School of MedicineToon CityJapan
| | - Yu Matsumoto
- Department of Neuropsychiatry, Molecules and FunctionEhime University Graduate School of MedicineToon CityJapan
| | - Saori Inoue
- Department of Neuropsychiatry, Molecules and FunctionEhime University Graduate School of MedicineToon CityJapan
| | - Maya Okazawa
- Department of Neuropsychiatry, Molecules and FunctionEhime University Graduate School of MedicineToon CityJapan
| | - Rie Hosokawa
- Department of Neuropsychiatry, Molecules and FunctionEhime University Graduate School of MedicineToon CityJapan
| | - Kiwamu Nakachi
- Department of Neuropsychiatry, Molecules and FunctionEhime University Graduate School of MedicineToon CityJapan
| | - Junya Soga
- Department of Neuropsychiatry, Molecules and FunctionEhime University Graduate School of MedicineToon CityJapan
| | - Shu‐Ichi Ueno
- Department of Neuropsychiatry, Molecules and FunctionEhime University Graduate School of MedicineToon CityJapan
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Barnard-Brak L, Kudesey C. Reported Side or Adverse Effects Associated with Medication Nonadherence Among Adolescents and Young Adults with Attention-Deficit/Hyperactivity Disorder. J Child Adolesc Psychopharmacol 2022; 32:539-542. [PMID: 36548362 DOI: 10.1089/cap.2022.0043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Background and Objective: The purpose of this study was to determine what side effects were most associated with medication nonadherence as reported by adolescents and young adults with attention-deficit/hyperactivity disorder (ADHD). Methods: A combination of multiple linear regression and chi-square automatic interaction detection techniques were utilized in analyzing the survey data responses of 157 adolescents and young adults with ADHD. Results: The mean number of side effects reported was M = 10.33 side effects with 77% of the sample reporting at least one side effect. In aggregate, the number or severity of side effects were not significantly associated with medication nonadherence. Rather, it was the severity of particular side effects, upset stomach and vomiting, which were significantly associated with medication nonadherence. Conclusions: Health care providers should utilize this information as an indicator that medication nonadherence will be an issue when these side effects are present.
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Affiliation(s)
- Lucy Barnard-Brak
- Department of Special Education and Multiple Abilities, The University of Alabama System, Tuscaloosa, Alabama, USA
| | - Carolina Kudesey
- Department of Special Education and Multiple Abilities, The University of Alabama System, Tuscaloosa, Alabama, USA
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Sullivan DP, Payne L, Boulton KA, Silove N, Bellgrove MA, Sciberras E, Coghill DR, Guastella AJ, Middeldorp CM. Examining the pharmacological and psychological treatment of child and adolescent ADHD in Australia: Protocol for a retrospective cohort study using linked national registry data. BMJ Open 2022; 12:e064920. [PMID: 36418141 PMCID: PMC9685201 DOI: 10.1136/bmjopen-2022-064920] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION Attention deficit hyperactivity disorder (ADHD) is a neurodevelopmental disorder which affects 5% of children globally. In Australia, it is estimated that 4.1% of children and adolescents have ADHD. While research has examined the treatment and outcomes of children with ADHD attending public mental health services during their time in the public system in Australia, it is not known what treatment they received before and after these treatment episodes, which will provide a more complete understanding of these children's treatment journey. METHODS AND ANALYSIS We will link clinical data from cohorts of children and adolescents treated in the public child and youth mental health and/or child development services in Brisbane, Melbourne and Sydney to the Medicare Benefits Schedule (MBS), Pharmaceutical Benefits Scheme (PBS) and National Death Index. MBS data will demonstrate the treatment journey with respect to clinicians seen, and treatment episodes from the public health service data sets will be examined to assess if the type and intensity of treatment are related to treatment outcomes. PBS data will reveal all psychotropic medications prescribed, allowing an examination of not just ADHD medications, but also other psychotropics which may indicate co-occurring conditions (eg, anxiety and mood disorders). Statistical analyses will include descriptive statistics to describe the rates of specific medications and clinician specialties seen. Linear and logistic regression will be used to model how treatment and sociodemographic variables relate to routinely collected outcome measures in the public health system while controlling for covarying factors. ETHICS AND DISSEMINATION This study has been approved by the following institutional ethics committees: (1) Children's Health Queensland Hospital and Health Service (HREC/21/QCHQ/76260), (2) The University of Queensland (2021/HE002143) and (3) The Australian Institute of Health and Welfare (EO2021/4/1300). Findings will be disseminated through peer-reviewed journals, conferences, professional associations and to public mental health services that treat ADHD.
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Affiliation(s)
- Daniel P Sullivan
- Child Health Research Centre, The University of Queensland, South Brisbane, Queensland, Australia
- Child and Youth Mental Health Service, Children's Health Queensland Hospital and Health Service, South Brisbane, Queensland, Australia
| | - Leanne Payne
- Child Health Research Centre, The University of Queensland, South Brisbane, Queensland, Australia
- Child and Youth Mental Health Service, Children's Health Queensland Hospital and Health Service, South Brisbane, Queensland, Australia
| | - Kelsie A Boulton
- Brain and Mind Centre, The University of Sydney, Sydney, New South Wales, Australia
- Clinic for Autism and Neurodevelopmental (CAN) Research, The University of Sydney, Sydney, New South Wales, Australia
| | - Natalie Silove
- Child Development Unit, The Sydney Children's Hospitals Network Randwick and Westmead, Westmead, New South Wales, Australia
| | - Mark A Bellgrove
- Turner Institute for Brain and Mental Health, School of Psychological Science, Monash University, Clayton, Victoria, Australia
| | - Emma Sciberras
- School of Psychology, Deakin University, Burwood, Victoria, Australia
- Deakin University Centre for Social and Early Emotional Development, Burwood, Victoria, Australia
| | - David R Coghill
- Departments of Paediatrics and Psychiatry, University of Melbourne, Melbourne, Victoria, Australia
- The Royal Children's Hospital Melbourne, Parkville, Victoria, Australia
| | - Adam J Guastella
- Clinic for Autism and Neurodevelopmental (CAN) Research, The University of Sydney, Sydney, New South Wales, Australia
- Clinical Research Unit, Brain and Mind Research Institute, Camperdown, New South Wales, Australia
| | - Christel M Middeldorp
- Child Health Research Centre, The University of Queensland, South Brisbane, Queensland, Australia
- Child and Youth Mental Health Service, Children's Health Queensland Hospital and Health Service, South Brisbane, Queensland, Australia
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Matthijssen AFM, Dietrich A, Kleine Deters R, Meinardi Y, Del Canho R, van de Loo GHH, Buitelaar JK, van den Hoofdakker BJ, Hoekstra PJ. Clinicians' Adherence to Guidelines When Initiating Methylphenidate Treatment. J Child Adolesc Psychopharmacol 2022; 32:488-495. [PMID: 36383094 DOI: 10.1089/cap.2022.0060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Aims: Between 2008 and 2012, the number of children and adolescents in the Netherlands who received methylphenidate prescriptions increased by 35.6%. We determined guideline adherence regarding the assessment of attention-deficit/hyperactivity disorder (ADHD) and rates of off-label use in those 2 years. We also compared adherence to guidelines between mental health and pediatrics settings. Methods: We conducted a medical file audit of 506 children or adolescents who had received a first methylphenidate prescription in 2008 (n = 208) or 2012 (n = 298) across mental health (n = 333) and pediatrics outpatient clinics (n = 173) in the Netherlands and assessed adherence to seven guideline recommendations. Results: We did not find significant differences between 2008 and 2012 regarding the mean adherence to the seven recommendations (43% vs. 45%) or the percentage of off-label use (35% vs. 30%). Best adherence rates (over the years 2008 and 2012 combined) concerned the assessment of comorbidities (89%) and the involvement of teachers in the diagnostic process (75%). Least frequently adhered to were assessing ADHD severity (1%), the use of a (semi-)structured parent interview (16%), and providing psycho-education to parents (42%) or teachers (1%). Mental health settings showed better adherence than pediatrics settings (over the years 2008 and 2012 combined) concerning the use of (semi-)structured parent interviews (22% vs. 3.1%), having a separate diagnostic session directed at the child (81% vs. 63%), assessment of comorbidities (95% vs. 76%), and providing psycho-education to parents (51% vs. 24%). Conclusions: There was neither a decrease in adherence to guidelines nor an increase in off-label use between 2008 and 2012. However, there is ample room for improvement regarding guideline adherence.
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Affiliation(s)
- Anne-Flore M Matthijssen
- Department of Child and Adolescent Psychiatry, University of Groningen, University Medical Centre Groningen, Groningen, The Netherlands
| | - Andrea Dietrich
- Department of Child and Adolescent Psychiatry, University of Groningen, University Medical Centre Groningen, Groningen, The Netherlands
| | - Renee Kleine Deters
- Department of Child and Adolescent Psychiatry, University of Groningen, University Medical Centre Groningen, Groningen, The Netherlands
| | - Yvonne Meinardi
- Department of Child and Adolescent Psychiatry, University of Groningen, University Medical Centre Groningen, Groningen, The Netherlands
| | - Riwka Del Canho
- Department of Pediatrics, Maasstad Hospital, Rotterdam, The Netherlands
| | - Gigi H H van de Loo
- Karakter Child and Adolescent Psychiatry Center Nijmegen, Nijmegen, The Netherlands
| | - Jan K Buitelaar
- Department of Cognitive Neuroscience, Radboud University Nijmegen Medical Center, Donders Institute for Brain, Cognition and Behavior, Nijmegen, The Netherlands
| | - Barbara J van den Hoofdakker
- Department of Child and Adolescent Psychiatry, University of Groningen, University Medical Centre Groningen, Groningen, The Netherlands.,Department of Clinical Psychology and Experimental Psychopathology, University of Groningen, Groningen, The Netherlands
| | - Pieter J Hoekstra
- Department of Child and Adolescent Psychiatry, University of Groningen, University Medical Centre Groningen, Groningen, The Netherlands
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Hoekstra PJ, Roessner V. Updated European guidelines for Tourette syndrome: and now use them! Eur Child Adolesc Psychiatry 2022; 31:371-373. [PMID: 35037103 DOI: 10.1007/s00787-021-01927-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Pieter J Hoekstra
- Department of Child and Adolescent Psychiatry, Accare Child Study Center, University of Groningen, University Medical Center Groningen, Groningen, Netherlands.
| | - Veit Roessner
- Department of Child and Adolescent Psychiatry, TU Dresden, Dresden, Germany
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Jaite C, Hoffmann F, Seidel A, Mattejat F, Bachmann C. [Outpatient Psychological Therapies in Children and Adolescents in Germany: Status Quo and Time Trends, 2009-2018]. PSYCHIATRISCHE PRAXIS 2021; 49:304-312. [PMID: 34352894 DOI: 10.1055/a-1540-4958] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
OBJECTIVE To determine the prevalence of outpatient psychological therapies (PT) in youths with statutory health insurance in Germany. METHODS Based on statutory health insurance funds data for 2009-2018, the prevalence of outpatient PT was assessed, stratified by sex, age, and federal state. Psychotherapeutic specialty, coded psychiatric diagnoses, and type of PT were also analysed. RESULTS In 2018, 7.3 % received any form of PT (2009: 7.1 %). Of these, 18.4 % (2009: 12.8 %) received therapy according to the directives for psychotherapy (dPT), with CBT (since 2012) being most frequently used. PT prevalence was highest in 15- to 19-year olds, and only marginally differed by sex. Child psychiatrists delivered the majority of PTs. Main diagnoses were anxiety/emotional disorders, ADHD, and adjustment disorders. CONCLUSION During the studied period, PT prevalence has not changed markedly. Yet, the share of dPT has increased, with CBT ranking top.
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Affiliation(s)
- Charlotte Jaite
- Charité - Universitätsmedizin Berlin, Klinik für Psychiatrie, Psychosomatik und Psychotherapie des Kindes- und Jugendalters
| | - Falk Hoffmann
- Carl von Ossietzky Universität Oldenburg, Abteilung Ambulante Versorgung und Pharmakoepidemiologie
| | - Anja Seidel
- Zentralinstitut für die kassenärztliche Versorgung in der Bundesrepublik Deutschland, Fachbereich Versorgungsforschung, Systemanalyse und Data Science
| | | | - Christian Bachmann
- Klinik für Kinder- und Jugendpsychiatrie/Psychotherapie, Universitätsklinikum Ulm
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